Postnasal Drip

Author: Op. Dr. Javidan Asafov · ENT / Otolaryngology Specialist · Last medical review: 21.10.2026

What is it?

The nose and sinuses constantly produce secretions to moisten and clean the air you breathe. Most of these secretions move from the back of the nose down into the throat and are swallowed without being noticed; this is completely normal.

Postnasal drip is when these secretions increase, become thicker or are noticed in the throat more than usual. The person feels that mucus is constantly building up in their throat. Postnasal drip is not a disease in itself; it is most often a symptom of a problem in the nose and sinuses. It is a common complaint; once the cause has been identified, treatment is planned accordingly.

Symptoms

Common symptoms are:

• A feeling of mucus running down the throat: the sensation of secretions dripping from the back of the nose into the throat.
• Frequent throat clearing: a repeated need throughout the day to swallow, clear the throat or bring up phlegm.
• Cough: a cough that gets worse especially when lying down at night and on getting up in the morning. Postnasal drip is one of the common causes of a long-lasting cough.
• Tickly throat: a feeling of itching, irritation or something catching in the throat.
• Hoarseness: a husky voice, especially in the morning (hoarseness).
• Bad breath: thick or infected discharge can cause an unpleasant smell on the breath (bad breath).
• Nausea: in some people, swallowed phlegm can cause a feeling of nausea, especially in the morning.

Causes

Sometimes more than one cause plays a part:

• Allergic rhinitis: it usually causes a clear, watery discharge, sneezing and itching (allergic rhinitis).
• Sinusitis: thick, yellow-green discharge may come with blockage and a feeling of fullness in the face (sinusitis).
• Viral infections: after a cold or flu, the discharge may continue for a while; it usually clears up on its own.
• Non-allergic rhinitis: cold air, spicy food, strong smells and cigarette smoke can make the nose run even without an allergy.
• Structural causes in the nose: a bend in the septum, the central wall of the nose (deviated septum), and enlarged turbinates (turbinate hypertrophy) can disturb airflow and the clearing of secretions.
• Reflux and silent reflux: stomach contents coming back up into the oesophagus, and even as far as the throat and larynx (laryngopharyngeal reflux), can cause a feeling of phlegm and drip in the throat. Reflux itself is not a nasal discharge; irritation of the throat and larynx creates a similar feeling.
• Some medicines: some blood pressure medicines and medicines containing hormones can affect the nasal lining; do not stop a medicine you are taking on your own; talk to your doctor.
• Dry air: in centrally heated or air-conditioned rooms, secretions thicken and are noticed more.
• Adenoids in children: enlarged adenoids can cause discharge, blockage and a night-time cough (adenoids and tonsils in children).

Examination and diagnosis

Assessment starts with a detailed history: you will be asked how long the discharge has been going on and what colour it is, and about nasal blockage, sneezing, heartburn or a sour taste in the mouth, smoking and the medicines you use. The inside of the nose, the back of the nose and the larynx are then examined endoscopically with a thin camera. This examination can show discharge coming from the sinuses, swelling of the lining, a deviated septum, polyps and signs of reflux-related irritation in the larynx.

If needed, allergy tests may be requested. If chronic sinusitis or polyps are suspected, a CT scan of the sinuses may be carried out.

Treatment

Treatment is planned according to the cause; your doctor decides which medicine to use and how. Commonly used methods are:

• Rinsing the nose with saline: it clears away thick secretions and allergens; it helps with almost every cause.
• Intranasal corticosteroid sprays: in allergic rhinitis and chronic sinusitis, they reduce swelling of the lining and secretions; their effect builds up with regular use.
• Antihistamines: they can be used as tablets or nasal sprays for discharge, sneezing and itching caused by allergy.
• Allergen avoidance: reducing contact with the allergen can ease symptoms.
• Treatment of sinusitis: if bacterial sinusitis is suspected, antibiotics may be given on the doctor’s advice.

If reflux is thought to be contributing to the symptoms, changes to diet and lifestyle come first: not eating late or heavy meals in the evening, not lying down straight after eating, losing excess weight, cutting down on foods and drinks that make symptoms worse, and stopping smoking. If needed, medicines that reduce stomach acid may be used on the doctor’s advice.

Decongestant nasal sprays can be used only for short-term relief; with long-term use they make blockage worse (nasal spray addiction).

Options that may be considered include endoscopic sinus surgery for chronic sinusitis and polyps that persist despite medical treatment, septoplasty for a deviated septum that markedly narrows the airway, turbinate reduction for enlarged turbinates and, in children, adenoid surgery (adenoidectomy) for enlarged adenoids that are causing symptoms.

What can you do at home?

• Drink enough fluids: drinking enough water during the day helps keep secretions runny.
• Rinse your nose: for saline rinsing, use a ready-made solution or one prepared with boiled and cooled or sterile water.
• Watch the humidity: in a very dry room, raising the humidity in moderation can bring relief; too much humidity leads to mould.
• Keep your head slightly raised: raising the head slightly when lying down can reduce night-time coughing and reflux.
• Stay away from irritants: cigarette smoke, strong smells and perfumes irritate the nose and throat.
• Try to clear your throat less: constant throat clearing irritates the throat further; swallowing or taking a sip of water instead helps.

When to see a specialist

It is advisable to see an ENT specialist if your postnasal drip has been going on for a long time, if constant throat clearing or coughing affects your daily life and sleep, or if it comes with nasal blockage, a feeling of fullness in the face or a reduced sense of smell. Do not put off an examination if the discharge comes from only one side of the nose, if there is often blood in the discharge or phlegm, or if you have difficulty swallowing, a swelling in the neck, shortness of breath or unexplained weight loss. Postnasal drip is usually not a sign of a serious disease; knowing the cause makes it easier to choose the right treatment.

This article is for general information; please consult your physician for diagnosis and treatment.